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Breast cancer screening using tomosynthesis in combination with digital mammography.

Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia.

Abstract:

IMPORTANCE

Mammography plays a key role in early breast cancer detection. Single-institution studies have shown that adding tomosynthesis to mammography increases cancer detection and reduces false-positive results.

OBJECTIVE

To determine if mammography combined with tomosynthesis is associated with better performance of breast screening programs in the United States.

DESIGN, SETTING, AND PARTICIPANTS

Retrospective analysis of screening performance metrics from 13 academic and nonacademic breast centers using mixed models adjusting for site as a random effect.

EXPOSURES

Period 1: digital mammography screening examinations 1 year before tomosynthesis implementation (start dates ranged from March 2010 to October 2011 through the date of tomosynthesis implementation); period 2: digital mammography plus tomosynthesis examinations from initiation of tomosynthesis screening (March 2011 to October 2012) through December 31, 2012.

CONCLUSIONS AND RELEVANCE

Addition of tomosynthesis to digital mammography was associated with a decrease in recall rate and an increase in cancer detection rate. Further studies are needed to assess the relationship to clinical outcomes.